Autograft, i.e., using the patient's own tissue, is considered to be the “gold standard” for bone grafting. However, its use continues to be limited due to donor site pain and morbidity issues. As a result, allograft bone grafting has gained popularity over the years. Issues related to disease transmission and sourcing, however, continue to be a deterrent to the use of allograft products.
Synthetic bone graft substitutes have also been used. Products in the synthetic bone graft substitute area include products that are primarily composed of βTCP or a mix of Hydroxyapatite and βTCP. These products have a variable resorption/degradation profile with hydroxyapatite taking up to years to resorb. Growth factor based products such as rh-BMP2 have also been used for bone grafting but have been associated with adverse events.
All of the above have resulted in the need for better and “safer” bone grafting alternatives. More recently, a class of products called synthetic bioactive bone graft substitutes has been considered.